Shift Work Nurses Research Articles

Psychological Aid to COVID-19 Pandemic: A Mental Health Response to Crises Management.

Catastrophic Pandemics have been adversely impacted the globe throughout human history. As a consequence psychiatrist, psychologist and mental health practitioners performed their role to mitigate the adverse impacts through its scientific and clinical lenses. It was observed that due to advance nature of COVI-19 pandemic, more advance approach of psychological aid is required. This work gives an overview of the multi-dimensional and trans-disciplinary techniques, which can be helpful to cope up with the crises that emerged from the threat of COVID-19 Outbreak for victims, survivors, health care practitioners and community.

Sleep diary- and actigraphy-derived sleep parameters of 8-hour fast-rotating shift work nurses: A prospective descriptive study

BackgroundGiven the harmful effects of night shifts and rotating schedules on nurses’ sleep and work performance, shift nurses’ sleep patterns have been a research concern. Actigraphy involves acquisition of data using a movement sensor worn continuously on the nondominant wrist, typically for a week or more. Although actigraphy provides objective and accurate sleep data, sleep diaries have been a practical alternative. However, there is a lack of research on the agreement and consistency between the two methods of measuring sleep for shift work nurses. In addition, differences in sleep patterns by shift types among 8-hour fast-rotating shift work nurses has not yet been examined. ObjectivesTo evaluate the agreement between the sleep diary and actigraphy methods for sleep assessment, and to compare sleep parameters of 8-hour fast-rotating shift work nurses according to shift type. DesignDescriptive and prospective study design. SettingsTwo tertiary hospitals in Seoul, South Korea. ParticipantsA total of 94 shift work nurses who wore actigraphy along with completing a sleep diary. MethodsSubjective and objective sleep parameters were recorded during a two-week period in a sleep diary and actigraphy, respectively. Bland-Altman plots and intraclass correlation coefficients were used to analyze the agreement between the two methods. Sleep parameters according to shift type were compared using the Kruskal–Wallis and Mann–Whitney U tests. ResultsGood agreement was observed between the sleep diary and the actigraphy data for total sleep time (intraclass correlation coefficients = 0.765 or 0.858) and variability in sleep time (intraclass correlation coefficients = 0.838). When compared to the actigraphy data, diary-derived data were overestimated by 41–45 min for total sleep time and 0.4% for variability in sleep time. There was a difference of 2–3 h of sleep quantity by shift type: 5.3–5.8 h for day shifts and 7.1–8.4 h for night shifts. ConclusionsA sleep diary can function as an acceptable alternative to actigraphy for measuring shift work nurses’ sleep patterns, specifically total sleep time and variability in sleep time. Given the high variability in sleep among shift work nurses, both personal and organizational efforts are required. Nurses should monitor their sleep quantity and develop their own regular sleep schedules to fit their work schedules. Hospitals should establish healthy schedules for nurses to guarantee sufficient sleep hours before work. Future research on shift work nurses’ sleep should examine fluctuations in sleep duration.

Fatigue and recovery in shiftworking nurses: A scoping literature review

ObjectivesTo identify factors impeding or enhancing recovery from fatigue in shiftworking nurses. DesignScoping literature review methodology was implemented to identify key concepts around recovery from fatigue in shiftworking nurses to provide a narrative around these paradigms. Data sourcesFive electronic data bases were searched: CINAHL, MEDLINE, PROQUEST Health and Medicine, ScienceDirect and PsycINFO to identify primary studies on fatigue and recovery in shiftworking nurses from 2000 to 2019 inclusive. Review methodsPreliminary searches were completed between September and December 2017 and finalised in January 2020. Research was drawn from nursing only samples employed under shiftwork scheduling. Results31 studies were included in this scoping review. Factors impeding and enhancing recovery at work and home are identified as impacting on fatigue outcomes. Findings indicate recovery from fatigue in shiftworking nurses are most significantly affected by high work and job demands and the 'when' and 'how' of shiftwork scheduling; all reported to impede recovery from shiftwork related fatigue. The most noteworthy facilitators of recovery were work control and control over shiftwork scheduling, break opportunities at work, age and being part of a family structure. There was a dearth of research identified around the time frames of the progression from acute to chronic fatigue and the in-depth role of recovery in this transition. As chronic or long-term fatigue can develop from an acute or recoverable fatigue this may significantly impact on shiftworking nurses' health and wellbeing. ConclusionsThis scoping review highlights the complicated nature of shiftwork scheduling and the impact it can have on recovery from fatigue in shiftworking nurses. Multiple methods and ways of measuring fatigue, recovery and shiftwork were identified in the studies. The results describe factors impeding and enhancing recovery from fatigue as occurring within both the workplace and during time away from work. Thus, this review provides improved understanding of the barriers and facilitators in recovery from fatigue and the potential accumulation of fatigue over time. These findings are important for shiftworking nurses, nursing managers and hospital administrators, and society, who are dependant on nurses' care.

Reduced Neuromuscular Performance in Night Shift Orthopedic Nurses: New Insights From a Combined Electromyographic and Force Signals Approach.

The effect of sleep–wake rhythm disruption on neuromuscular control and muscle fatigue has received little attention. Because nurse shift work is so varied, including overnight duty, rotating shift schedules, early awakening, and interrupted nocturnal sleep, it offers an interesting model to study this paradigm. It has been investigated so far using only subjective markers. A combined approach based on the simultaneous analysis of surface electromyographic (sEMG) and force signals can objectively detect possible deficits in neuromuscular control and muscle fatigue. With this study we investigated neuromuscular activation and muscle contraction capacity at submaximum and maximum level in nurses working two night-shift schedules and compared them to levels in nurses working entirely in day shifts. Sleep quality and activity levels were also assessed. The study sample was 71 nurses grouped by their shift work schedule: night shift for 5 days (NS5, n = 46), night shift for 10 days (NS10, n = 9), and only day/swing shift (DS, n = 16). Before and after the shift-work cycle, maximum voluntary contraction (MVC) force and muscle activation, neuromuscular control, and muscle fatigability were measured in the finger flexor muscles. Activity level and sleep quality during the shift-work cycle were recorded with a wrist actigraph. After the shift-work cycles, MVC force and muscle activation were decreased (−11 ± 3% and −33 ± 3%, p < 0.001) as was neuromuscular control (−36 ± 8%, p = 0.007), whereas muscle fatigability was increased (+ 19 ± 9%, p = 0.006) in the NS5 and the NS10 group. Sleep quality was lower in the NS5 and the NS10 group (−8 ± 1.8% and −15%3, respectively, p < 0.001), while the activity level for the three groups was similar. There was a clear reduction in neuromuscular control and an increase in muscle fatigue in the nurses working the night shift. These findings may inform of work schedule planning or recommendations for devising new recovery strategies to counteract neuromuscular alterations in night shift nurses.

Sleep disturbance-related depressive symptom and brain volume reduction in shift-working nurses

Disturbed sleep is the most common effect of shift work. A large corpus of research indicates an association between sleep disturbance and depressive symptom in shift workers. In this study, we proposed the mediating role of grey matter (GM) structure in the relationship between sleep disturbance and depressive symptom. We collected structural MRI (sMRI) data as well as assessing the level of sleep disturbance and depressive symptom with the Pittsburgh Sleep disturbance Index and Zung Self-Rating Depression Scale, respectively, in 20 shift-working nurses and 19 day-working nurses. The shift-working nurses reported greater severity of sleep disturbance and depressive symptom, and furthermore, they exhibited reduced GM volume in the left postcentral gyrus (PostCG), right PostCG, right paracentral lobule, and left superior temporal gyrus (STG), compared to the day-working nurses. For each of the four brain regions, we formulated a mediation hypothesis by developing a mediation model that represents a causal chain between GM volume, sleep disturbance, and depressive symptom. Tests of the hypothesis on the mediation of GM volume revealed that inter-individual variations in left PostCG volume and left STG volume accounted for the influence of sleep disturbance on depressive symptom. These results suggest that structural alterations in PostCG and STG play an intervening role in the development of depressive symptom following sleep disturbance. We propose the need of considering neuroanatomical abnormalities in explaining and understanding symptomatic changes induced by sleep disturbance.

Association between Health Problems and Turnover Intention in Shift Work Nurses: Health Problem Clustering.

Shift work nurses experience multiple health problems due to irregular shifts and heavy job demands. However, the comorbidity patterns of nurses’ health problems and the association between health problems and turnover intention have rarely been studied. This study aimed to identify and cluster shift work nurses’ health problems and to reveal the associations between health problems and turnover intention. In this cross-sectional study, we analyzed data from 500 nurses who worked at two tertiary hospitals in Seoul, South Korea. Data, including turnover intention and nine types of health issues, were collected between March 2018 and April 2019. Hierarchical clustering and multiple ordinal logistic regressions were used for the data analysis. Among the participants, 22.2% expressed turnover intention and the mean number of health problems was 4.5 (range 0–9). Using multiple ordinal logistic regressions analysis, it was shown that sleep disturbance, depression, fatigue, a gastrointestinal disorder, and leg or foot discomfort as a single health problem significantly increased turnover intention. After clustering the health problems, four clusters were identified and only the neuropsychological cluster—sleep disturbance, fatigue, and depression—significantly increased turnover intention. We propose that health problems within the neuropsychological cluster must receive close attention and be addressed simultaneously to decrease nurse’s turnover intentions.

0214 The Relationship Between Work Stress and Sleep Quality in Shift Working Nurses: The Intermediate Effect of Circadian Rhythm Amplitude and Stability

Abstract Introduction Research suggests that work stress may be an important factor in poor sleep in shift working nurses. However, evidence is limited about the underlying mechanism. Circadian rhythm might be effective. The purpose of this study was to explore the relationship between work stress and sleep quality in shift working nurses and the mediation effect of circadian rhythm amplitude and stability respectively. Methods A total of 529 nurses working in shifts from seven hospitals were selected by convenient sampling in Shanghai, China. Participants were assessed with the Circadian Type Inventory (CTI), Chinese Nursing Stressor Scale (CNSS), Pittsburgh Sleep Quality Index (PSQI). The Amos24.0 software was applied to construct structural equation models with circadian rhythm amplitude (LV) and circadian rhythm stability (FR) as intermediate variables respectively. Results About 73.3% (388/529) of the nurses’ PSQI scores were above 5, indicating poor sleep quality. The correlations between work stress, circadian rhythm amplitude, circadian rhythm amplitude and sleep quality were all significant (all P&amp;lt;0.01).Sleep quality total score was positively correlated with work stress(γ=0.348) and circadian rhythm amplitude (γ=0.330). Work stress was positively correlated with circadian rhythm amplitude (γ=0.297,P&amp;lt;0.01). Sleep quality total score was negatively correlated circadian rhythm amplitude (γ=-0.204,P&amp;lt;0.01);Work stress was negatively correlated with circadian rhythm amplitude (γ= -0.284,P&amp;lt;0.01).Work stress showed significant indirect effects on sleep quality through the mediating effect of circadian rhythm amplitude (β=0.188,P&amp;lt;0.01) and circadian rhythm amplitude (β= 0.082,P&amp;lt;0.05). Conclusion It suggests that nurses working in shifts have poor sleep quality. Work stress and the amplitude and stability of circadian rhythm could affect sleep quality, and circadian rhythm amplitude and stability could mediate the relationship between work stress and sleep quality. Support The work was supported by Xinglin Young Talent Program of Shanghai University of Traditional Chinese Medicine(to Caiqin Wu) and The 12th Innovative activities of college students of Shanghai Traditional Chinese Medicine(2019SHUTCM094).

Sleep disorder among shift work nurses and its impact on their quality of life at Al Ahrar Governmental Hospital, Zagazig City, Egypt

Background Shift work sleep disorder is a crucial occupational health problem for nurses that not only causes health problems for them but also affects patient’s safety and job performance. Objective The aim was to assess the magnitude of sleep disorders among shift working nurses at Al Ahrar Governmental Hospital and to determine the associations between sleep disorders and work characteristics and their impact on quality of life. Materials and methods A comparative cross-sectional study was conducted among 180 nurses. Data collection was done by using Pittsburgh Sleep Quality Index to measure the quality of sleep, insomnia severity index to measure self-perception of insomnia symptoms, Epworth sleepiness scale to measure daytime sleepiness symptoms, and functional outcome of sleep questionnaire to measure the quality of life. Results It has been estimated that 73% of shift work nurses are suffering from poor subjective sleep quality compared with the morning shift group (20%) and 60% of shift work nurses had sleep disturbances compared with 36.7% among the morning shift group with a significant difference ( Conclusion Shift work sleep disorders are prevalent and important health concerns among nurses. Nurses’ sleep disorders can affect the patient’s safety by affecting the nurse’s performance and care quality. Therefore, planning for improving work shift schedules by hospital administration can be helpful and the use of day rest after night shift work can improve the sleep quality of nurses.

The relationship between urolithiasis, metabolic syndrome and nurse shift work. A literature review

AbstractThe shift work increased the metabolic syndrome and urolithiasis in nurses? Problem metabolic syndrome and urolithiasis are two worldwide important health problems. Shift work and consequent sleep disorders are risk factors of developing metabolic syndrome. The aim of this literature review is to describe the effects of shift work on metabolic syndrome and urolithiasis in nurses. Search terms (free terms, MeSH): ‘metabolic syndrome’, ‘urologic diseases’; papers published in the last 10 years (2009‐2019) were searched in some databases (PUBMED, CINAHL, Scopus, Embase and Cochrane Database of Systematic Review). We included all randomized controlled trials (RCTs), observational studies, reviews and we included papers studying metabolic syndrome and urolithiasis. Quality assessment of the papers was verified according to Dixon‐Woods checklist. Seven articles were analysed. The literature review has shown that insulin resistance, hypertension, obesity, cardio vascular disease have a relationship with metabolic syndrome. People with obesity, insulin resistance or hypertension have a low urinary pH. The prevalence of obesity and insulin resistance has increased the risk of urolithiasis in both men and women. This risk has further increased in shift workers especially in nurses. There seems to be a bilateral association between hypertension and urolithiasis. Nurses are a population at risk of developing metabolic syndrome and consequently urolithiasis. It is important to understand whether nurses may be at risk of urolithiasis, to prevent bad habits and to anticipate days off. Nurses are a population at risk of developing metabolic syndrome and consequently urolithiasis.

Sleep Improvement Effect on Sexual Life Quality Among Rotating Female Shift Workers: A Randomized Controlled Trial

BackgroundPoor sleep quality consequences among shift working nurses are well recognized. AimTo investigate the impact of sleep improvement on sexual quality of life. MethodsThe study was a parallel randomized controlled trial, conducted among 120 female nurses in 2 educational hospitals in the Northeast of Iran, Shahroud. Using random blocks of four, 120 eligible participants were randomly assigned to study groups. Data collecting tools included a demographic data questionnaire, Pittsburgh Sleep Quality Index to assess sleep quality, and the survey of sexual quality of life-female and Sexual Self-Efficacy Questionnaire to evaluate level of sexual quality of life and sexual self-efficacy, respectively. The intervention consisted of 3 weekly sleep intervention sessions that lasted from 90 to 120 minutes. OutcomesThe study's primary and secondary outcomes were sleep quality, and the level of sexual self-efficacy and sexual quality of life, respectively. ResultsBy 3-month follow-up, the loss to follow-up rate was 5.9%. The mean sleep quality score was 7.61 ± 2.26 in the recruited participants. Following the intervention, the sleep quality score showed statistically significant differences compared to the control group [mean difference (CI 99.98%), −1.89 (−2.40, −1.38)]. Participants in the intervention group showed modest increases in both measures; sexual self-efficacy [mean difference (CI 99.98%), 8.82 (6.83, 10.81)] and sexual quality of life [mean difference (CI 99.98%), 19.64 (18.08, 21.20)]. Clinical ImplicationsThese findings suggest that sleep improvement could promote the sexual quality of life among shift working nurses. Strengths & LimitationsStrengths of this study include the use of a validated outcome measure. Focusing the study on female nurses and the small size of the study population are the limitations. ConclusionImproved sleep showed an impact on sexual quality of life among rotating female shift workers.Khastar H, Mirrezaie SM, Chashmi NA, et al. Sleep Improvement Effect on Sexual Life Quality Among Rotating Female Shift Workers: A Randomized Controlled Trial. J Sex Med 2020;17:1467–1475.

Hospital and Shift Work Influences on Nurses' Dietary Behaviors: A Qualitative Study.

Background: Nurses working in hospitals face unique influences on their workplace dietary behaviors, but little is known about what nurses experience as dietary influencers in the hospital setting. Understanding these influences is paramount in developing effective programs that target healthy workplace eating. This study aimed to explore hospital shift nurses' experiences and perceptions of influences on making healthy nutritional choices while at work. Methods: This qualitative, descriptive study was guided by the Theoretical Domains Framework and analyzed using thematic analysis. Twenty-one Registered Nurses working 10- to 12-hour shifts in hospitals in South Carolina, USA, in 2018 were interviewed individually or in focus groups about their workplace dietary behaviors and influences. Findings: Framework constructs most relevant to hospital shift nurses included (a) environmental context and resources; (b) social/professional role and identity; (c) memory, attention, and decision processes; (d) social influences; (e) emotion; and (f) behavioral regulation. In addition, four major themes emerged: (a) Nursing roles and responsibilities restrict freedom of movement and minimize individual control over dietary practices; (b) The hospital food environment is oppressively unhealthy; (c) Free food is currency and influences consumption; and (d) Shift work is a major barrier to healthy eating. Conclusions/Applications to Practice: To achieve healthy eating practices in the workplace, hospital shift nurses need supportive systems, policies, and interventions that target and reduce the barriers inherent in hospital-based nursing shift work. To improve hospital shift nurses' workplace dietary behaviors, these findings should inform hospital food policies, workplace wellness programs, administrative practices, and staff education.

Predictors of Blood and Body Fluid Exposure and Mediating Effects of Infection Prevention Behavior in Shift-Working Nurses: Application of Analysis Method for Zero-Inflated Count Data

This study aimed to identify the predictors of blood and body fluid exposure (BBFE) in multifaceted individual (sleep disturbance and fatigue), occupational (occupational stress), and organizational (hospital safety climate) factors, as well as infection prevention behavior. We also aimed to test the mediating effect of infection prevention behavior in relation to multifaceted factors and the frequency of BBFE. This study was based on a secondary data analysis, using data of 246 nurses from the Shift Work Nurses' Health and Turnover study. Based on the characteristics of zero-inflated and over-dispersed count data of frequencies of BBFE, the data were analyzed to calculate zero-inflated negative binomial regression within a generalized linear model and to test the mediating effect using SPSS 25.0, Stata 14.1, and PROCESS macro. We found that the frequency of BBFE increased in subjects with disturbed sleep (IRR = 1.87, p = .049), and the probability of non-BBFE increased in subjects showing higher infection prevention behavior (IRR = 15.05, p = .006) and a hospital safety climate (IRR = 28.46, p = .018). We also found that infection prevention behavior had mediating effects on the occupational stress-BBFE and hospital safety climate-BBFE relationships. Sleep disturbance is an important risk factor related to frequency of BBFE, whereas preventive factors are infection prevention behavior and hospital safety climate. We suggest individual and systemic efforts to improve sleep, occupational stress, and hospital safety climate to prevent BBFE occurrence.

The effectiveness of bright light exposure in shift-worker nurses: A systematic review and meta-analysis.

Bright light exposure is as one of the non-pharmacological measures to sleep management in shift-worker. This study was conducted to determine the effectiveness of bright light exposure in shift-worker nurses. We performed a systematic review and meta-analysis according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement and using existing literature in the following databases: Cochrane Library, Embase, PubMed, Scopus, Web of Science, to examine any eligible and relevant interventional (randomized controlled trial, experimental and quasi-experimental studies) which were published by December 31, 2018. The obtained documents were analyzed using Stata 14.1 and Cochrane Collaboration's RevMan 5.3. Five studies met eligibility criteria. Results from fixed-effect meta-analysis of the included studies revealed that the exposure could decrease the sleepiness levels, complaints related to shift-work, insomnia and increased the psychomotor error (95% confidence interval (CI): -0.87,-0.43, p=0.000, I2=98.6%), alertness and daytime sleep duration following night shifts (95% CI: 0.08,0.99, p=0.000, I2=92.7%). However, in the random effects model, none of them were statistically significant. Although the results of fixed-effect are in favor of beneficial effects of bright light exposure in shift-worker nurses, the random effects could not approve these findings. Maybe because of either large heterogeneity or insufficiency of the number of studies. Besides, because of the low number of studies, it was impossible to deal with high amount of heterogeneity using subgroup analysis or meta-regression. So the controversy on this topic continues to persist, which highlights the need for more well-designed randomized control trials with larger sample sizes in the future.

Secondary Data Analysis on the Factors Influencing Premenstrual Symptoms of Shift Work Nurses: Focused on the Sleep and Occupational Stress

This study aimed to examine premenstrual symptoms (PMS) of shift nurses and identify the association between PMS, sleep, and occupational stress. This study was conducted with a secondary data analysis that used data from the Shift Work Nurse's Health and Turnover study. The participants were 258 nurses who were working in shifts including night shifts. PMS, sleep patterns (sleep time and sleep time variability), sleep quality, and the occupational stress of each participant were measured using the Moos Menstrual Distress Questionnaire, a sleep diary, an actigraph, the Insomnia Severity Index, and the Korean Occupational Stress Scale, respectively. Data were analyzed using SPSS 23 and STATA 15.1 to obtain descriptive statistics, Pearson's correlation coefficients, multiple linear regression with generalized estimating equations (GEE) and Baron and Kenny's mediating analysis. The average PMS score, average sleep time, average sleep time variability, average sleep quality score, and average occupational stress score of the participants was 53.95 ± 40.45, 7.52 ± 0.89 hours, 32.84 ± 8.43%, 12.34 ± 5.95, and 49.89 ± 8.98, respectively. A multiple linear regression analysis with GEE indicated that sleep time variability (B = 0.86, p = .001), and sleep quality (B = 2.36, p < .001) had negative effects on nurses' PMS. We also found that sleep quality had a complete mediating effect in the relationship between occupational stress and PMS. These findings indicate that both sleep time variability and sleep quality are important factors associated with PMS among shift work nurses. To improve shift nurses' PMS status, strategies are urgently needed to decrease sleep time variability and increase sleep quality.

Vardiyalı Çalışan Hemşirelerde Mesleki Yorgunluğu Etkileyen Faktörlerin Belirlenmesi

Purpose:This study aims to determine the occupational fatigue and the factors affecting occupational fatigue in shift working nurses. Methods: This descriptive study was carried out at Harran University Research and Application Hospital between the dates of February-March 2020. The sample of the study consisted of 318 nurses. Introductory information form, which was prepared by the researchers, the Occupational Fatigue Exhaustion/Recovery Scale (OFER) and the Pittsburg Sleep Quality Index (PSQI) were used as Data Collection tools. Findings: Subscale mean scores were found as follows respectively: 66.84 ± 24.01 for chronic fatigue, 70.03 ± 22.49 for acute fatigue, 40.19 ± 18.91 for recovery and 9.1 3± 3.39 for the Pittsburgh Sleep Quality Index. 10.1% of employees have good sleep quality, 89.9% of them have bad sleep quality. Conclusions: It was found that healthcare professional’s quality of sleep, income status, job satisfaction, choosing their profession voluntarily, means of transportation to their workplace, the clinic they work, having a physical or mental complaint, setting aside time for himself/herself and making exercise affect their occupational fatigue. It is suggested to determine and make necessary interventions to minimize the occupational fatigue of nurses that has an important and critical place in the provision of healthcare.

Secondary Data Analysis on the Quality of Sleep and Related Factors of Novice and Experienced Shift Work Nurses

The purpose of this study was to identify the quality of sleep in novice and experienced shift work nurses and compare the factors associated with their quality of sleep. We analyzed the data of 192 and 256 novice and experienced nurses, respectively. The quality of sleep, sleep hygiene, job stress, and fatigue were measured using Insomnia Severity Index, Sleep Hygiene Practice Scale, the Korean Occupational Stress Scale, and Fatigue Severity Scale. Data were analyzed using SPSS 25.0 to calculate descriptive statistics and logistic regression. Sleep quality was lower in experienced nurses (12.55 ± 5.71) than in novice nurses (11.18 ± 5.78). Fatigue was more severe in experienced nurses (4.47 ± 1.13) than in novice nurses (4.23 ± 1.12). In the logistic regression, factors related to sleep quality in novice nurses were sleep hygiene (odds ratio; OR = 1.06, p < .001) and fatigue (OR = 2.49, p < .001). Factors related to sleep quality in the experienced nurses were also sleep hygiene (OR = 1.04, p = .001) and fatigue (OR = 1.53, p = .012). Sleep quality of experienced nurses is lower than those of novice nurses. Factors associated with sleep quality in novice and experienced nurses are equally identified as sleep hygiene and fatigue. Therefore, personal efforts to improve sleep hygiene, such as providing comfortable sleep environment, are needed. Furthermore, organized efforts to decrease fatigue, such as constructing a working environment with a bright light at night and providing a fatigue-decreasing program that includes meditation, are required.

Working Conditions of Shift-Working Nurses and Conditions that Enable Them to Continue Working: An Online Survey

Working Conditions of Shift-Working Nurses and Conditions that Enable Them to Continue Working: An Online Survey

Sleep quality among shift-work nurses: A systematic review and meta-analysis

AimWe systematically reviewed the quality of sleep measurement instruments applied to shift-work nurses and analyzed the effects of intervention research. BackgroundThere is a need to test the effects of experimental studies worldwide that conducted interventions to improve the sleep quality of nurses who work shiftwork. MethodsIn this systematic literature review and meta-analysis, we used PICO (Participant, Intervention, Comparison, and Outcome) and searched for papers in Korean and English published up until August 2018. We utilized Cochrane Review Manager Software 5.3. ResultsThirteen articles from 1991 to 2018 were included in the systematic literature review, and 6 of those were used in a meta-analysis. The instrument used most often to asses subjective sleep quality was the Pittsburgh Sleep Quality Index. Additionally, an actigraph and sleep logs were used to collect physiological data about participants' sleep quality. Intervention types were categorized into aroma-inhalation therapy, shift-rotation interventions, physical-activity interventions, and cognitive-behavioral therapy. Ultimately, the effects of the aroma-inhalation therapy intervention significantly improved shift-work nurses' sleep quality. ConclusionsWe established a basic understanding of a strategy to measure and improve participants' sleep quality. Consequently, sleep interventions that can positively promote nurses' health and foster effective job performance should be developed.

Lifestyle and Shiftwork: Designing and Testing a Model for Health Promotion of Iranian Nurses.

BACKGROUND: Lifestyle is one factor that forms the nurses' health, particularly those who work in shiftwork schedules. AIMS: The aim of this study was to design and test a model for health promotion of Iranian nurses. In this model, nurses' lifestyle was considered as the precedent, physical and mental health as the outcomes, and sleep disturbance and chronic fatigue as the mediators. METHODS: A cross-sectional study using structural equation modeling was conducted among 240 shiftworker nurses in Iran. The data collection was performed using the Persian versions of the Survey of Shiftworkers Questionnaire and Life Style Questionnaire. Bootstrap in Preacher and Hayes' Macro program was used for testing mediation. RESULTS: Lifestyle had a weak significant direct effect on physical (β = 0.13, p < .04) and mental health (β = 0.12, p < .02), and it had a significant indirect effect on physical health via chronic fatigue (β = -0.11, p < .001) and sleep disturbance (β = -0.05, p < .01). This variable only had a significant indirect effect on mental health via chronic fatigue (β = -0.19, p < .001). The final model proposed a new significant path between sleep disturbances and chronic fatigue (β = 0.22, p < .001). CONCLUSIONS: Therefore, the hospital officials can enhance the nurses' physical and mental well-being by providing interventions and training courses on aspects of healthy lifestyles, such as physical activity, avoidance of smoking, and maintenance of body weight.

Morningness-Eveningness Chronotypes, Sleep Quality, and Sleepiness Among Nurses

Background:Poor sleep quality and sleepiness is a common problem in nurses. The morningness-eveningness preference of nurses may affect their sleep quality.Objective:The objectives of this study were (1) to describe the quality of sleep in a group of hospital nurses and (2) to analyze the effect of shift work and morningness-eveningness on the sleep quality of nurses.Methods:In this cross-sectional study, 120 nurses completed the survey in a university hospital in Iran. The study tools were Pittsburgh Sleep Quality Questionnaire (PSQI), Epworth Sleepiness Scale (ESS), and Morningness-Eveningness Questionnaire (MEQ). Nurses with PSQI&gt;5 and ESS≥10 were considered having poor sleep quality and excessive daytime sleepiness. Nurses were subdivided into morning-, intermediate- and evening-types according to MEQ. Data were analyzed by chi-square, Mann–Whitney U-test, logistic regression, and analysis of covariance (ANCOVA) tests.Results:The mean (±SD) of PSQI and ESS was 6.88(2.18) and 9.5(±3.9), respectively. About 74% of nurses reported poor sleep quality, and near 40% of the nurses had excessive daytime sleepiness. Sixty percent of nurses were intermediate-type, and the remaining was morning (24.2%) and evening (15.8%) types. The sleep quality and daytime sleepiness had a significant relation with shift work. The mean PSQI was significantly different between shift work and non-shift work nurses. The mean PSQI of three main chronotypes was statistically different.Conclusion:Poor sleep quality was prevalent in the nurses and was significantly associated with shift work and chronotype. The sleep preference of nurses would be considered as an important factor in the assignment of shift work by hospital managers.